title: Intensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS.
abstract: OBJECTIVE
  To determine the incidence and outcomes of intensive care unit-acquired neuromyopathy and to investigate the role of methylprednisolone in survivors of persistent acute lung injury.
  
  
  METHODS
  Secondary analysis of completed randomized placebo-controlled trial.
  
  
  METHODS
  Twenty-five hospitals in the NHLBI ARDS Network.
  
  
  METHODS
  Patients enrolled in the ARDS Network study of methylprednisolone versus placebo for persistent ARDS who survived 60 days or to hospital discharge.
  
  
  RESULTS
  One hundred and twenty-eight study patients survived 60 days. Forty-three (34%) of these patients had evidence by chart review of ICU-acquired neuromyopathy, which was associated with prolonged mechanical ventilation, return to mechanical ventilation, and delayed return to home after critical illness. Treatment with methylprednisolone was not significantly associated with an increase in risk of neuromyopathy (OR 1.5; 95% CI 0.7-3.2).
  
  
  CONCLUSIONS
  ICU-acquired-neuromyopathy is common among survivors of persistent ARDS and is associated with poorer clinical outcomes. We did not find a significant association between methylprednisolone treatment and neuromyopathy. Limitations of this study preclude definitive conclusions about the causal relationship between corticosteroids and ICU-acquired neuromuscular dysfunction.
authors.affiliation: Department of Medicine and The NHLBI ARDS Network, University of Washington, 325 Ninth Avenue, Mailstop 359762, Seattle, WA 98104, USA. cterrlee@u.washington.edu
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Steinberg
authors.forename: B
authors.initials: B
authors.lastname: Taylor Thompson
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Rubenfeld
authors.forename: Leonard D
authors.initials: LD
authors.lastname: Hudson
mesh_terms: D055371:Acute Lung Injury / Q000150:complications / Q000188:drug therapy; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects*; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D011115:Polyneuropathies / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D017741:Survivors; D014481:United States / Q000453:epidemiology
chemical_list: D008775:Methylprednisolone